Figure Legends
Figure 1: Diagram of
the anti-cancer mechanism of TTFields. (A) During metaphase
mitosis, tubulin will align in the direction of the EF, resulting in
interference with its polymerization and thus impaired chromosome
segregation. (B) During cell division, the cell morphology
under TTFields (hourglass-like shape) produces an inhomogeneous
intracellular EF, and all polar macromolecules and organelles will be
pushed towards the CCF. In addition to interfering with mitosis,
TTFields has multiple biological mechanisms, including: (C)inhibiting DSB repair, enhancing DNA replication pressure, (D)inhibiting tumor cell migration and metastasis, (E) promoting
autophagy, and (F) inflammatory responses to kill tumor cells,(G) increasing cell membrane and (H) BBB permeability
to facilitate the uptake of agents.
Figure 2: Images
before TTFields and during follow-up of a 73-year-old patient with GBM.Due to an immune thrombocytopenia, only TTFields was applied 4 weeks
after completion of radiotherapy with concomitant TMZ. Before TTFields,
baseline FET PET images showed a slight increase in metabolic activity
(TBRmax 2.0, TBRmean 1.6) without spatial counterpart contrast
enhancement. Sequential FET PET images at 3 and 6 months follow-up
showed a decrease in metabolic activity, as evidenced by a decreased
tumor-to-brain ratio. Compared to MRI T1 images, FET PET images showed
clearer lesions. Adapted permission from [ ref. 91].
Table I: The summary of finished clinical studies of TTFields
in brain tumors.